摘要
[目的]探讨比较加压螺钉联合支撑钢板技术与单纯加压螺钉技术治疗LetenneurⅡ-Ⅲ型Hoffa骨折的临床疗效。[方法]2008年6月~2018年10月本院收治的42例LetenneurⅡ-Ⅲ型Hoffa骨折患者,随机分为两组,21例给予支撑钢板联合拉力螺钉固定,21例采用单纯螺钉固定。比较两组围手术期资料、膝关节活动范围(ROM)、KSS评分及影像资料。[结果]两组患者均顺利完成手术,未发生血管、神经损伤等严重并发症。钢板螺钉组在手术切口长度、出血量、手术时间、术中辐射时间、住院费用方面显著大于单纯螺钉组,差异具有统计学意义(P<0.05)。42例患者随访12个月以上。术后完全负重行走时间钢板螺钉组为(10.62±1.60)周,单纯螺钉组为(12.81±2.64)周,两组间差异有统计学意义(P<0.05)。两组患者均随术后时间推移,ROM和KSS评分显著增加,差异有统计学意义(P<0.05),术后3、12个月随访时,钢板螺钉组ROM和KSS评分均显著大于单纯螺钉组,差异有统计学意义(P<0.05)。至末次随访时,钢板螺钉组出现1例骨不连,但内固定物无松动、断裂;单纯螺钉组出现2例畸形愈合,螺钉移位。[结论]尽管在手术时间、切口长度、术中失血量和手术费用方面存有劣势,拉力螺钉联合支撑钢板技术治疗LetenneurⅡ-Ⅲ型Hoffa骨折的临床效果优于单纯拉力螺钉固定。
[Objective]To compare the clinical outcomes of the buttress plate combined with lag screw versus lag screw only for a single Letenneur typeⅡ-ⅢHoffa fracture.[Methods]From June 2008 to October 2018,42 patients with a single Letenneur typeⅡ-ⅢHoffa fracture were randomly divided into two groups,including 21 patients who had the fracture fixed with buttress plate combined with lag screw(the BPLS group),and the remaining 21 patients who had the facture fixed by lag screw only(the LSO group).The perioperative parameters,knee range of motion(ROM),Knee Society Score(KSS)and radiographic presentations were compared between the two groups.[Results]All the patients underwent successful surgical procedures without serious complications,such as neurovascular injuries.The BPLS group proved significantly greater than the LSO group regarding to operation time,incision length,intraoperative blood loss,radiation exposure time,hospital stay and hospitalization expenses(P<0.05).The 42 patients were followed up for more than 12 months.The full weight-bearing ambulation time after operation proved of(10.62±1.60)weeks in the BPLS group,whereas(12.81±2.64)weeks in the LSO group,which was statistically significant(P<0.05).In addition,both the ROM and KSS score significantly increased as time went postoperatively(P<0.05),which in the BPLS group proved significantly greater than those in the LSO group at 3 and 12 months postoperatively(P<0.05).To the latest follow up,1 patient in the BPLS group suffered from nonunion on radiograph without loosening or breaking of the implants,whereas 2 patients in the LSO group had malunion of the fracture with displacement of the screws.[Conclusion]Despite of the fact that the buttress plat combined with lag screw takes disadvantage over the lag screw only in operation time,incision length,intraoperative blood loss,radiation exposure time,hospital stay and hospitalization expenses,the former achieves considerably better clinical outcomes than the latter for Letenneur typeⅡ-Ⅲtype Hoffa fractu
作者
李震
陈贞月
王小谭
李景银
LI Zhen;CHEN Zhen-yue;WANG Xiao-tan;LI Jing-yin(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;The Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan250011,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第14期1264-1268,共5页
Orthopedic Journal of China
基金
山东省高校基金
山东省高校中医药协同创新项目(编号:XTCX2014A01-02)
山东省高等学校科技计划项目(编号:J14LK07)
